Comparing post-operative outcomes of patients with intracapsular neck of femur fractures treated with hip hemiarthroplasty versus total hip arthroplasty

Abstract

Aims
To compare post-operative outcomes for patients who had sustained an intracapsular hip fracture and had been treated with either hip hemiarthroplasty(HA) or total hip arthroplasty (THA). Our primary outcome measured was post-operative inpatient mortality.

Methods
Retrospective data was collected from the Irish Hip Fracture Database on all patients treated for intracapsular neck of femur fractures with either THA or HA from January 2013 to December 2015. Data analysis was carried out using SPSS Version 25

Results
4,259 patients were included in this study of which 3,956 (92.9%) underwent treatment with HA and 303 (7.1%) were treated with THA. 4% of the HA group died as an inpatient versus 0.6% of the THA group (p=0.002). 23% of the HA group and 17% of the THA cohort were delayed mobilising after surgery (p=0.029). Length of stay for those treated with THA was 12.87 days versus 18.88 for HA (p<0.01).

Discussion
Patients treated with THA had a lower post-operative mortality rate as an inpatient and more likely to mobilise early after surgery. THA was associated with reduced LOS when compared to HA for treatment of intracapsular NOF fractures. THA should be considered in younger patients with few comorbidities who mobilise well pre-fracture.